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巨细胞病毒(Cytomegalovirus,CMV)感染是同种异基因型骨髓移植(ALLO-BMT)后的发病和死亡的主要原因,大约有50%的ALLO-BMT 患者发生了CMV 感染。临床上可以无症状,也可以表现为肺炎,胃肠炎,发热以及有时表现为肝炎症状。虽然在自身移植和同基因移植患者也有相同比例的CMV 感染发生,但是临床上较少引起症状。近年来大量研究提示,使用血清CMV 阴性的血制品、静脉注射免疫球蛋白(IgG)和抗病毒制剂的应用对预防或减轻移植后的CMV 感染是有益处的,然而对这些措施的应用指征和禁忌仍然存在着争论,本文就着重讨论这些争论并试图阐明防治CMV 感染的有效手段。
Cytomegalovirus (CMV) infection is the leading cause of morbidity and mortality after allogeneic bone marrow transplantation (ALLO-BMT). About 50% of ALLO-BMT patients develop CMV infection. Clinically asymptomatic, can also be manifested as pneumonia, gastroenteritis, fever and sometimes manifested as hepatitis symptoms. Although CMV infection occurs in the same proportions in both autologous and syngeneic patients, it is less clinically relevant. In recent years, a large number of studies have suggested that the use of serum CMV-negative blood products, intravenous immunoglobulin (IgG) and antiviral agents may be beneficial in preventing or reducing CMV infection after transplantation, however, indications for the use of these measures There are still controversies and taboos, this article focuses on these debates and attempts to clarify the effective means of prevention and treatment of CMV infection.